松原 健太郎 (マツバラ ケンタロウ)

MATSUBARA, Kentaro

写真a

所属(所属キャンパス)

医学部 外科学教室(一般・消化器) Department of Surgery (信濃町)

職名

専任講師(有期)

HP

学歴 【 表示 / 非表示

  • 2000年03月

    慶應義塾大学, 医学部

    大学

学位 【 表示 / 非表示

  • 医学博士, 慶應義塾大学, 2013年03月

 

研究分野 【 表示 / 非表示

  • 外科学一般

  • 消化器外科学

  • 心臓血管外科学

研究キーワード 【 表示 / 非表示

  • 子宮移植

  • 肝移植

  • 脱細胞化

  • 血管外科

研究テーマ 【 表示 / 非表示

  • 異物を残さない組織再生型ステントグラフトの開発, 

    2014年01月
    -
    継続中

 

論文 【 表示 / 非表示

  • A Hybrid Technique to Manage a Large Perigraft Seroma after an Open Abdominal Aortic Aneurysm Repair: A Case Report

    Ono S., Obara H., Hagiwara K., Saida F., Oshiro K., Matsubara K., Shibutani S., Kitagawa Y.

    Annals of Vascular Surgery (Annals of Vascular Surgery)  56   352.e1 - 352.e4 2019年04月

    ISSN  08905096

     概要を見る

    © 2018 Elsevier Inc. Perigraft seroma (PGS) is a relatively rare complication of aortoiliac reconstructive surgery. We, herein, describe a case of a large PGS that was managed by using a hybrid technique of relining the original graft with simultaneous open drainage. An 86-year-old man with a 17.3-cm diameter PGS after prosthetic bifurcated graft replacement for abdominal aortic aneurysm was admitted to our hospital. He presented with abdominal distension and discomfort and had difficulty in taking food. The entire relining of the original covered stent graft with GORE ® EXCLUDER ® using aortic extension cuff and iliac extenders and simultaneous open evacuation of PGS were successfully performed. The symptoms of the patient totally improved, and no recurrence was detected at 2 years after the operation. This technique would be a feasible treatment option for this rare complication.

  • A Pre-Clinical Large Animal Model of Sustained Liver Injury and Regeneration Stimulus

    Inomata K., Tajima K., Yagi H., Higashi H., Shimoda H., Matsubara K., Hibi T., Abe Y., Tsujikawa H., Kitago M., Shinoda M., Obara H., Itano O., Soto-Gutierrez A., Kitagawa Y.

    Scientific Reports (Scientific Reports)  8 ( 1 )  2018年12月

     概要を見る

    © 2018, The Author(s). A feasible large animal model to evaluate regenerative medicine techniques is vital for developing clinical applications. One such appropriate model could be to use retrorsine (RS) together with partial hepatectomy (PH). Here, we have developed the first porcine model using RS and PH. RS or saline control was administered intraperitoneally to Göttingen miniature pigs twice, two weeks apart. Four weeks after the second dose, animals underwent PH. Initially, we tested different doses of RS and resection of different amounts of liver, and selected 50 mg/kg RS with 60% hepatectomy as our model for further testing. Treated animals were sacrificed 3, 10, 17 or 28 days after PH. Blood samples and resected liver were collected. Serum and liver RS content was determined by Liquid Chromatograph-tandem Mass Spectrometer. Blood analyses demonstrated liver dysfunction after PH. Liver regeneration was significantly inhibited 10 and 17 days after PH in RS-treated animals, to the extent of 20%. Histological examination indicated hepatic injury and regenerative responses after PH. Immunohistochemical staining demonstrated accumulation of Cyclin D1 and suppression of Ki-67 and PCNA in RS-treated animals. We report the development of the first large animal model of sustained liver injury with suppression of hepatic regeneration.

  • Decreased Incidence of Acute Cellular Rejection in Low-Muscle-Mass Recipients After Living-donor Liver Transplantation

    Wakabayashi T., Shinoda M., Obara H., Kitago M., Yagi H., Abe Y., Matsubara K., Yamada Y., Oshima G., Hirukawa K., Mizota T., Hibi T., Itano O., Hoshino K., Kuroda T., Kitagawa Y.

    Transplantation Proceedings (Transplantation Proceedings)  50 ( 10 ) 3626 - 3634 2018年12月

    ISSN  00411345

     概要を見る

    © 2018 Elsevier Inc. Background: Sarcopenia has recently been studied as a potential risk factor for mortality and complications after liver transplantation. We investigated the impact of low muscle mass on postoperative outcomes after living-donor liver transplantation. Methods: Our study population consisted of 100 adult recipients who underwent living-donor liver transplantation in our department between 2005 and 2017. Recipients were divided into a low-muscle-mass group (L group) and a normal-muscle-mass group (N group) based on skeletal muscle index (SMI) values, and postoperative outcomes were compared between the groups. Regarding factors that were significantly different between the groups, multivariate analyses were performed to identify predictive factors. Results: Based on the SMI definition, 47 and 53 of the recipients were categorized as having low muscle mass (L group) and normal muscle mass (N group), respectively. Comparison between the groups revealed a significantly reduced incidence of rejection (10.6% in L group vs 30.2% in N group, P =.017) and increased incidences of bacterial infection (61.7% in L group vs 37.7% in N group, P =.017) in the L group compared with the N group. The survival rate did not differ significantly between the groups. Multivariate analyses indicated that muscle mass was a significant predictive factor for both rejection and bacterial infection. Conclusion: It is important to recognize that muscle mass has an impact not only on bacterial infection but also on rejection in recipients with low muscle mass in the postoperative course of living-donor liver transplantation.

  • Early sac shrinkage is a good surrogate marker of durable success after endovascular aneurysm repair in Japanese patients

    Fujimura N., Matsubara K., Takahara M., Harada H., Asami A., Shibutani S., Watada S., Obara H., Kitagawa Y.

    Journal of Vascular Surgery (Journal of Vascular Surgery)  67 ( 5 ) 1410 - 1418.e1 2018年05月

    ISSN  07415214

     概要を見る

    © 2017 Society for Vascular Surgery Objective: The applicability of early sac shrinkage as a predictor of a low risk of late complications after endovascular aneurysm repair (EVAR) in Asian populations has not been validated. This study aimed to analyze early sac shrinkage and its relationship with late complications in Asian people using a Japanese multicenter database. We also assessed the impact of endoleaks. Methods: A retrospective analysis of 697 patients who had undergone EVAR of abdominal aortic aneurysms from 2008 to 2015 and were followed up for at least 1 year was conducted. Late complications were defined as any aneurysm-related events occurring >1 year after EVAR, including >5-mm aneurysm sac enlargements and any reinterventions performed. Endoleaks without any evidence of sac enlargement or a requirement for additional treatment were not considered late complications. Results: Early sac shrinkage, defined as a >5-mm-diameter decrease within 1 year of EVAR, occurred in 335 patients (48.1%); type I endoleaks (T1ELs) and isolated type II endoleaks (iT2ELs; type II endoleaks without evidence of other endoleaks) were observed in 4.0% and 29.4%, respectively. During the mean follow-up period of 45.5 months, 93 late complications (13.3%) occurred. Kaplan-Meier curve and log-rank analyses showed that early sac shrinkage was a significant predictor for a lower risk of late complications (P <.001). Multivariate analysis revealed that early sac shrinkage was independently associated with a lower risk of late complications (adjusted hazard ratio, 0.425; P =.004). Conversely, T1ELs and iT2ELs were positively associated with late complication (adjusted hazard ratio, 11.774 and 5.137, respectively; both P <.001). Subsequent multivariate analysis demonstrated that T1ELs and iT2ELs were negatively associated with early sac shrinkage (adjusted odds ratio, 0.102 and 0.285, respectively; both P <.001). Conclusions: Early sac shrinkage was associated with a low risk of late complications in Asian people and may be a good surrogate marker of durable success after EVAR. T1ELs and iT2ELs were negatively associated with early sac shrinkage and positively associated with late complications. Along with the high incidence of iT2ELs observed, T2ELs may be an important condition to consider after EVAR in the Asian population.

  • Successful management of living donor liver transplantation for biliary atresia with single ventricle physiology—from peri-transplant through total cavopulmonary connection: A case report

    Yamada Y., Hoshino K., Oyanagi T., Gatayama R., Maeda J., Katori N., Fuchimoto Y., Hibi T., Shinoda M., Matsubara K., Obara H., Aeba R., Kitagawa Y., Yamagishi H., Kuroda T.

    Pediatric Transplantation (Pediatric Transplantation)  22 ( 3 )  2018年05月

    ISSN  13973142

     概要を見る

    © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd Children with single ventricle physiology have complete mixing of the pulmonary and systemic circulations, requiring staged procedures to achieve a separation of these circulations, or Fontan circulation. The single ventricle physiology significantly increases the risk of mortality in children undergoing non-cardiac surgery. As liver transplantation for patients with single ventricle physiology is particularly challenging, only a few reports have been published. We herein report a case of successful LDLTx for an 8-month-old pediatric patient with biliary atresia, heterotaxy, and complex heart disease of single ventricle physiology. The cardiac anomalies included total anomalous pulmonary venous return type IIb, intermediate atrioventricular septal defect, tricuspid regurgitation grade III, coarctation of aorta, interrupted inferior vena cava, bilateral superior vena cava, and polysplenia syndrome. Following LDLTx, the patient sequentially underwent total cavopulmonary shunt + Damus-Kaye-Stansel at 3 years of age and extracardiac total cavopulmonary connection (EC-TCPC) completion at 5 years of age; 7 years have now passed since LDLTx (2 years post–EC-TCPC). We describe the details of the management of LTx in the presence of cardiac anomalies and report the long-term cardiac and liver function, from peri-LDLTx through EC-TCPC completion.

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KOARA(リポジトリ)収録論文等 【 表示 / 非表示

総説・解説等 【 表示 / 非表示

研究発表 【 表示 / 非表示

  • Super-extended surgery for recurrent liposarcoma: Where are the limits?

    Hibi T, Abe Y, Shinoda M, Kitago M, Yagi H, Matsubara K, Obara H, Kitagawa Y

    第6回アジア太平洋肝胆膵学会・第29回日本肝胆膵外科学会学術集会, 2017年06月, その他

  • ハイリスク患者の大腿動脈TASC-D 病変に対する血管外科的アプローチ

    松原健太郎, 尾原秀明, 北川雄光

    第45回日本血管外科学会学術総会 (広島) , 2017年04月, シンポジウム・ワークショップ パネル(公募)

  • 腹部大動脈ステントグラフト感染に対する治療

    松原健太郎, 尾原秀明, 掛札敏裕, 和多田晋, 内田智夫, 朝見淳規, 原田裕久, 関本康人, 渋谷慎太郎, 小野滋司, 大住幸司, 秋好沢林, 藤井琢, 藤村直樹, 新谷恒弘, 北川雄光

    第47回日本心臓血管外科学会学術総会 (東京) , 2017年02月, シンポジウム・ワークショップ パネル(公募)

  • 当科関連多施設台帳を用いたEVAR後の遠隔期合併症および早期瘤退縮の検討

    藤村直樹, 尾原秀明, 松原健太郎, 掛札敏裕, 和多田晋, 内田智夫, 朝見淳規, 渋谷慎太郎, 小野滋司, 秋好沢林, 藤井琢, 大住幸司, 原田裕久, 関本康人, 北川雄光

    第45回日本血管外科学会学術総会 (広島) , 2017年, シンポジウム・ワークショップ パネル(公募)

  • Clinical Outcome of Common Femoral Artery Endarterectomy for Occlusive Disease

    Hayashi K, Obara H, Matsubara K, Hayashi M, Shimogawara T, Kitagawa Y

    40th World Congress of the International College of Surgeons (Kyoto) , 2016年10月, シンポジウム・ワークショップ パネル(公募)

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競争的資金等の研究課題 【 表示 / 非表示

  • 脱細胞化、再細胞化技術を用いた再生型カバードステントの開発

    2018年04月
    -
    2021年03月

    文部科学省・日本学術振興会, 科学研究費助成事業, 松原 健太郎, 若手研究, 補助金,  代表

  • 血管新生促進作用を持つ末梢動脈用生体吸収性ステントの開発

    2014年04月
    -
    2017年03月

    文部科学省・日本学術振興会, 科学研究費助成事業, 松原 健太郎, 若手研究(B), 補助金,  代表

     研究概要を見る

    末梢動脈疾患の新たな治療方法の開発を目指し、G-CSF溶出生体吸収性ステントの開発を目的に研究を開始したが、予備実験結果をふまえて実験計画を修正した。金属ステントをコントロールとし、生体吸収性ステントのブタ腸骨動脈における開存性や血管壁反応の違いの検討を先行させた。留置6週間後の病理学的検討で、生体吸収性ステントは金属ステントと比較して、狭窄率、血管壁炎症、損傷スコアに違いはないものの、新生内膜面積で縮小傾向、中膜面積で拡大傾向を認めた。この基礎データをもとに薬剤溶出生体吸収性ステント作成に着手しつつある。またブタ下肢虚血モデルの作成実験を重ね、手術手技、虚血肢の血管撮影手技などを確立した。

受賞 【 表示 / 非表示

  • Young Investigator Travel Award Cell transplantation Society

    2013年07月